Off-The-Shelf or Custom-Fitted Orthotic Lookup Tool for Prefabricated Orthoses Only

Utilize this tool to assist in determining the correct HCPCS code in billing prefabricated orthotic claims. Is the orthotic off-the-shelf or custom-fitted or is there a corresponding code that may be billed depending on the action taken at time of delivery? Off-the-shelf requires minimal self-adjustment and custom-fitted requires more than minimal self-adjustment by a certified orthotist or an individual who has equivalent specialized training.

Disclaimer: This tool does not guarantee coverage for the item(s) billed.

Last Updated May 07 , 2024